Update To Access Standards Drive Time Calculations, 42724-42726 [2020-14341]

Download as PDF khammond on DSKJM1Z7X2PROD with RULES 42724 Federal Register / Vol. 85, No. 136 / Wednesday, July 15, 2020 / Rules and Regulations (b) Sections 101(d)(3) and 113, chapter 47,1 and chapter 80 of title 10, United States Code. (c) DoD Instruction 6495.02, ‘‘Sexual Assault Prevention and Response (SAPR) Program Procedures,’’ May 24, 2017, as amended (available at https:// www.esd.whs.mil/Portals/54/Documents/DD/ issuances/dodi/649502p.pdf). (d) 32 CFR part 158, ‘‘Operational Contract Support.’’ (e) DoD Manual 6400.01, Volume 2, ‘‘Family Advocacy Program (FAP): Child Abuse and Domestic Abuse Incident Reporting System,’’ August 11, 2016 (available at https://www.esd.whs.mil/ Portals/54/Documents/DD/issuances/dodm/ 640001m_vol2.pdf). (f) Public Law 114–92, ‘‘National Defense Authorization Act for Fiscal Year 2016,’’ November 25, 2015. (g) DoD Directive 7050.06, ‘‘Military Whistleblower Protection,’’ April 17, 2015 (available at https://www.esd.whs.mil/ Portals/54/Documents/DD/issuances/dodd/ 705006p.pdf). (h) U.S. Department of Justice, Office on Violence Against Women, ‘‘A National Protocol for Sexual Assault Medical Forensic Examinations, Adults/Adolescents,’’ current version (available at https://www.ncjrs.gov/ pdffiles1/ovw/241903.pdf). (i) 32 CFR part 310, ‘‘DoD Privacy Program.’’ (j) DoD Manual 6025.18, ‘‘Implementation of the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule in DOD Health Care Programs,’’ March 13, 2019 (available at https://www.esd.whs.mil/ Portals/54/Documents/DD/issuances/dodm/ 602518m.pdf?ver=2019-03-13-123513-717). (k) Public Law 113–66, ‘‘The National Defense Authorization Act for Fiscal Year 2014,’’ December 2013. (l) Title 5, United States Code. (m) Public Law 104–191, ‘‘Health Insurance Portability and Accountability Act of 1996,’’ August 21, 1996. (n) DoD Instruction 5505.18, ‘‘Investigation of Adult Sexual Assault in the Department of Defense,’’ March 22, 2017, as amended (available at https://www.esd.whs.mil/ Portals/54/Documents/DD/issuances/dodi/ 550518p.pdf?ver=2018-02-13-125046-630). (o) Sections 584, 585, and 586 of Public Law 112–81, ‘‘National Defense Authorization Act for Fiscal Year 2012,’’ December 31, 2011. (p) Public Law 113–291, ‘‘Carl Levin and Howard P. ‘Buck’ McKeon National Defense Authorization Act for Fiscal Year 2015,’’ December 29, 2014. (q) DoD Manual 8910.01, Volume 1, ‘‘DoD Information Collections Manual: Procedures for DoD Internal Information Collections,’’ June 30, 2014, as amended (available at https://www.esd.whs.mil/Portals/54/ Documents/DD/issuances/dodm/891001m_ vol1.pdf). (r) Public Law 110–417, ‘‘The Duncan Hunter National Defense Authorization Act for Fiscal Year 2009,’’ October 14, 2008. 1 Chapter 47 is also known and referred to in this part as ‘‘The Uniform Code of Military Justice (UCMJ).’’ VerDate Sep<11>2014 15:52 Jul 14, 2020 Jkt 250001 (s) DoD Instruction 5545.02, ‘‘DoD Policy for Congressional Authorization and Appropriations Reporting Requirements,’’ December 19, 2008 (available at https:// www.esd.whs.mil/Portals/54/Documents/DD/ issuances/dodi/554502p.pdf). (t) DoD Directive 5124.02, ‘‘Under Secretary of Defense for Personnel and Readiness (USD(P&R)),’’ June 23, 2008 (available at https://www.esd.whs.mil/ Portals/54/Documents/DD/issuances/dodd/ 512402p.pdf). (u) Public Law 112–81, ‘‘National Defense Authorization Act for Fiscal Year 2012,’’ December 31, 2011. (v) Department of Defense 2014–2016 Sexual Assault Prevention Strategy,’’ April 30, 2014, https://www.sapr.mil/index.php/ prevention. (w) DoD Instruction 6495.03, ‘‘Defense Sexual Assault Advocate Certification Program (D–SAACP),’’ September 10, 2015 (available at https://www.esd.whs.mil/ Portals/54/Documents/DD/issuances/dodi/ 649503p.pdf). (x) Section 577 of Public Law 108–375, ‘‘Ronald Reagan National Defense Authorization Act for Fiscal Year 2005,’’ October 28, 2004. (y) U.S. Department of Defense, ‘‘Manual for Courts-Martial, United States,’’ current edition (available at https://jsc.defense.gov/ Portals/99/Documents/ MCM2016.pdf?ver=2016-12-08-181411-957). (z) Title 10, United States Code. (aa) DoD Instruction 1030.2, ‘‘Victim and Witness Assistance Procedures,’’ June 4, 2004 (available at https://www.esd.whs.mil/ Portals/54/Documents/DD/issuances/dodi/ 103002p.pdf). (bb) DoD Instruction 5505.19, ‘‘Establishment of Special Victim Investigation and Prosecution (SVIP) Capability within the Military Criminal Investigative Organizations (MCIOs),’’ February 3, 2015, as amended (available at https://www.esd.whs.mil/Portals/54/ Documents/DD/issuances/dodi/ 550519p.pdf). (cc) Directive-type Memorandum 14–003, ‘‘DoD Implementation of Special Victim Capability (SVC) Prosecution and Legal Support,’’ February 12, 2014, as amended (available at https://www.esd.whs.mil/ Portals/54/Documents/DD/issuances/dtm/ DTM14003_2014.pdf). (dd) Title 32, United States Code. (ee) Sections 561, 562, and 563 of Public Law 110–417, ‘‘Duncan Hunter National Defense Authorization Act for Fiscal Year 2009,’’ October 14, 2008. (ff) U.S. Department of Justice, Office on Violence Against Women, ‘‘National Training Standards for Sexual Assault Medical Forensic Examiners,’’ current version (available at https://www.ncjrs.gov/pdffiles/ ovw/241903). (gg) DoD Instruction 6025.13, ‘‘Medical Quality Assurance (MQA) and Clinical Quality Management in the Military Health System (MHS),’’ February 17, 2011, as amended (available at https:// www.esd.whs.mil/Portals/54/Documents/DD/ issuances/dodi/602513p.pdf). (hh) Office of the Chairman of the Joint Chiefs of Staff, ‘‘DoD Dictionary of Military PO 00000 Frm 00038 Fmt 4700 Sfmt 4700 and Associated Terms,’’ current edition (available at https://www.jcs.mil/Portals/36/ Documents/Doctrine/pubs/dictionary.pdf). (ii) DoD 4165.66–M, ‘‘Base Redevelopment and Realignment Manual,’’ March 1, 2006 (available at https://www.esd.whs.mil/ Portals/54/Documents/DD/issuances/dodm/ 416566m.pdf). (jj) Public Law 111–84, National Defense Authorization Act for Fiscal Year 2010. (kk) 10 U.S.C. Chapter 47, Uniform Code of Military Justice. Dated: June 18, 2020. Aaron T. Siegel, Alternate OSD Federal Register Liaison Officer, Department of Defense. [FR Doc. 2020–13513 Filed 7–14–20; 8:45 am] BILLING CODE 5001–06–P DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 17 Update To Access Standards Drive Time Calculations Department of Veterans Affairs. Guidance. AGENCY: ACTION: This Department of Veterans Affairs (VA) document provides additional information regarding VA’s calculation of average drive times for purposes of eligibility determinations for covered veterans to access community care through the Veterans Community Care Program. DATES: Effective August 14, 2020. FOR FURTHER INFORMATION CONTACT: Joseph Duran, Office of Community Care (10D), Veterans Health Administration (VHA), Department of Veterans Affairs, Ptarmigan at Cherry Creek, Denver, CO 80209; Joseph.Duran2@va.gov; 303–370–1637 (this is not a toll-free number). SUPPLEMENTARY INFORMATION: On June 5, 2019, VA published a final rule at 84 FR 26278 to promulgate 38 CFR 17.4000– 17.4040 to implement the Veterans Community Care Program established by section 101 of the John S. McCain III, Daniel K. Akaka, and Samuel R. Johnson VA Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2018 (MISSION Act), Public Law 115–182. Section 17.4040 established access standards for purposes of making eligibility determinations under the Veterans Community Care Program under § 17.4010(a)(4). For primary care, mental health care, and noninstitutional extended care services, eligibility is established if VA cannot schedule an appointment for the covered veteran with a VA health care SUMMARY: E:\FR\FM\15JYR1.SGM 15JYR1 khammond on DSKJM1Z7X2PROD with RULES Federal Register / Vol. 85, No. 136 / Wednesday, July 15, 2020 / Rules and Regulations provider for the required care or service: (i) Within 30 minutes average driving time of the veteran’s residence; and (ii) Within 20 days of the date of request unless a later date has been agreed to by the veteran in consultation with the VA health care provider. For specialty care, eligibility is established if VA cannot schedule an appointment for the covered veteran with a VA health care provider for the required care or service: (i) Within 60 minutes average driving time of the veteran’s residence; and (ii) Within 28 days of the date of request unless a later date has been agreed to by the veteran in consultation with the VA health care provider. VA noted in § 17.4040(b) that to calculate average driving time from the veteran’s residence in paragraph (a) of the section, VA would use geographic information system software. In the preamble to the final rule, VA explained that it was not detailing in regulation a specific methodology for calculating average drive time because it was more veteran-centric to maintain operational flexibility to refine and improve VA’s average drive-time calculations in response to experience, feedback and changing real-world conditions. See 84 FR 26278, 26299. This final rule further stated that as VA gained more experience with administering the Veterans Community Care Program and received feedback from veterans regarding their experience with the program, VA anticipated refining the tool to calculate average drive times as well as VA systems to improve our consideration of actual conditions that affect travel to receive care and services and to provide more information to veterans regarding calculation of average drive times. See 84 FR 26278, 26301. This notice serves to inform the public that VA is will change the geographic information system software used to the calculate average drive times under § 17.4040. Description of Changes in Calculating Average Drive Times: As described in the final rule establishing the Veterans Community Care Program (84 FR 26278), VA uses a variety of factors, including distance, route options, and speed limits to calculate the average drive time between the veteran’s residence (as noted in VA’s enrollment system) and VA facilities that offer the type of care needed by the Veteran. The calculation is similar to the calculations used in popular commercial mapping software used for point-to-point driving directions and estimated travel times. The calculated average is used to determine whether the veteran is eligible for community care based on drive time. The final rule also stated VerDate Sep<11>2014 15:52 Jul 14, 2020 Jkt 250001 that, in response to comments that requested clarification on how VA will calculate average drive times, that some detailed information regarding average drive time calculations and algorithms is proprietary, and VA was unable to disclose the full method used to make the calculations. See 84 FR 26278, 26300. VA recognized the concerns voiced by veterans and members of the public at the time we launched the Veterans Community Care Program regarding how we calculate average drive time and whether we are making the best estimates of average drive times. This notice about planned refinements is the result of VA’s efforts to continue improving how we calculate this important component of eligibility. VA is refining the average drive-time calculations in the online Decision Support Tool (DST) to improve eligibility determination results and response times based on feedback received from veterans and VA staff regarding their experiences with the Veterans Community Care Program since its implementation on June 6, 2019. Effective August 14, 2020, VA will use a new geographic information system within DST. Under the new system, VA will determine drive times between two addresses by developing ‘‘service areas’’ around all VA facilities, which are bands surrounding the facility that reflect drive times in ranges of 10-minute increments, starting with 0–10 minutes, going up to 81–90 minutes. The applicable drive-time standards depend on the type of care being requested (i.e., the veteran can get needed care within 30 minutes’ average drive time for primary care, mental health care and extended care services under § 17.4040(a)(1)(i) or within 60 minutes for specialty care services under § 17.4040(a)(2)(i)). Users of the system will get an estimate of the drive time between the veteran’s residence and the VA facility in a 10-minute range under the bands, instead of a single-time estimate as in the current system. Covered veterans whose residence address is within a drive-time service area range that exceeds the drive-time standards for the type of care being sought would be determined to be eligible under § 17.4010(a)(4). The new system will use historical traffic patterns in all searches. The system will calculate average drive times based on historical traffic patterns on Wednesdays at 10 a.m. at the veteran’s local time for all searches. We have selected this time and day of the week to reasonably approximate times that veterans would be traveling for PO 00000 Frm 00039 Fmt 4700 Sfmt 4700 42725 appointments, while working within the capabilities of the system and the available data. Historical traffic data will be updated two to three times per year to reflect changes in local travel patterns. Veterans will benefit from this change in two ways. First, VA believes the new system will better reflect the actual conditions that affect the time it takes for veterans to travel to receive care and services because of the way that historical traffic data will be used and how average travel times will be calculated. Second, we can now offer more information to veterans and the public regarding how VA will calculate average drive times under this new system. While VA is primarily making this change to improve eligibility determination results and response times, it will also impact eligibility under the access standards for some veterans. VA believes the result will be an overall increase in eligibility. We note that the average drive time is only one element of covered veterans’ eligibility for community care. Since VA established the Veterans Community Care Program on June 6, 2019, covered veterans have also been eligible for community care under other criteria (see 38 CFR 17.4010, Veteran Eligibility). For example, covered veterans who would not be considered eligible for community care based solely on the average drive time element of the designated access standard criterion may still be eligible for community care if the veteran and his or her VA provider agree that it is in the best medical interest of the veteran to receive community care. We remain committed to ensuring that covered veterans are referred to community care where it is in their best medical interest, and veterans with concerns about whether they should be referred to the community are always welcome to discuss their options with their VA providers. Although we are changing the method of calculating average drive times in our DST tool, which may affect some individuals’ eligibility, this notice is not changing VA’s designated drive time access standard under § 17.4040. The average drive times that establish eligibility under the designated access standards criterion will remain the same after VA updates the average drive-time calculation tool. VA continues to believe it is more veteran-centric to maintain the operational flexibility to refine and improve VA’s calculations in response to experience, feedback and changing real-world conditions, rather than to detail in regulation a specific E:\FR\FM\15JYR1.SGM 15JYR1 42726 Federal Register / Vol. 85, No. 136 / Wednesday, July 15, 2020 / Rules and Regulations methodology or considerations that could constrain VA’s ability to improve the calculation of average drive times in the future. For that reason, we will continue to update the public through documents in the Federal Register about any changes to how we calculate average drive times for the Veterans Community Care Program. Signing Authority The Secretary of Veterans Affairs, or designee, approved this document and authorized the undersigned to sign and submit the document to the Office of the Federal Register for publication electronically as an official document of the Department of Veterans Affairs. Brooks D. Tucker, Acting Chief of Staff, Department of Veterans Affairs, approved this document on June 23, 2020 for publication. Jeffrey M. Martin, Assistant Director, Office of Regulation Policy & Management, Office of the Secretary, Department of Veterans Affairs. [FR Doc. 2020–14341 Filed 7–14–20; 8:45 am] BILLING CODE 8320–01–P ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA–R09–OAR–2019–0633; FRL–10011– 25–Region 9] Air Plan Approval; Arizona; Maricopa County Air Quality Department and Pima County Department of Environmental Quality Environmental Protection Agency (EPA). ACTION: Final rule. AGENCY: The Environmental Protection Agency (EPA) is taking final action to approve revisions to the Maricopa County Air Quality Department (MCAQD) and Pima County Department of Environmental Quality (PCDEQ) portions of the Arizona State Implementation Plan (SIP). These revisions concern emissions of particulate matter (PM) from nonmetallic mineral processing, inactive mineral tailings and slag storage. We are approving local rules that regulate these emission sources under the Clean Air Act (CAA or the Act). DATES: These rules will be effective on August 14, 2020. ADDRESSES: The EPA has established a docket for this action under Docket ID No. EPA–R09–OAR–2019–0633. All SUMMARY: documents in the docket are listed on the https://www.regulations.gov website. Although listed in the index, some information is not publicly available, e.g., Confidential Business Information (CBI) or other information whose disclosure is restricted by statute. Certain other material, such as copyrighted material, is not placed on the internet and will be publicly available only in hard copy form. Publicly available docket materials are available through https:// www.regulations.gov, or please contact the person identified in the FOR FURTHER INFORMATION CONTACT section for additional availability information. FOR FURTHER INFORMATION CONTACT: Christine Vineyard, EPA Region IX, 75 Hawthorne St., San Francisco, CA 94105. By phone: (415) 947–4125 or by email at vineyard.christine@epa.gov. SUPPLEMENTARY INFORMATION: Throughout this document, ‘‘we,’’ ‘‘us’’ and ‘‘our’’ refer to the EPA. Table of Contents I. Proposed Action II. Public Comments and EPA Responses III. EPA Action IV. Incorporation by Reference V. Statutory and Executive Order Reviews I. Proposed Action On May 1, 2020 (85 FR 25379), the EPA proposed to approve the following rules into the Arizona SIP. Adopted/ revised Local agency Rule No. Rule title MCAQD .......... PDEQ ............. 316 ......................................... Pima County Code Section 17.16.125. Nonmetallic Mineral Processing ............................................. Inactive Mineral Tailings Impoundment and Slag Storage Area within the Ajo PM Planning Area. Submitted 11/07/18 11/19/18 1 01/22/19 2 05/10/19 1 Pima County Board of Supervisors adopted PCC Section 17.16.125 on January 22, 2019, with an effective date of February 21, 2019. submitted PCC Section 17.16.125 as part of a larger SIP revision submittal titled ‘‘SIP Revision: Ajo PM10 Redesignation Request and Maintenance Plan (May 3, 2019)’’ (herein referred to as the ‘‘Ajo PM10 SIP’’). More specifically, appendix C of the Ajo PM10 SIP includes PCC Section 17.16.125 and the related adoption materials. ADEQ submitted the Ajo PM10 SIP electronically on May 10, 2019, under cover of a transmittal letter dated May 8, 2019. Herein, EPA is taking final action on the PCC Section 17.16.125 portion of the Ajo PM10 SIP. The EPA is taking action on the rest of the Ajo PM10 Plan in a separate action (85 FR 34381 (June 4, 2020)). khammond on DSKJM1Z7X2PROD with RULES 2 ADEQ We proposed to approve these rules because we determined that they comply with the relevant CAA requirements. More specifically, with respect to MCAQD Rule 316, we previously determined that the rule implemented Best Available Control Measures for nonmetallic mineral processing within the Phoenix planning area, and we find that the 2018 amendments to the rule relax no control requirements and generally clarify and enhance the effectiveness of the rule. With respect to Pima County Code (PCC) Section 17.16.125, we find that the rule provides a means to ensure the permanence and enforceability of the fugitive dust controls that have already VerDate Sep<11>2014 15:52 Jul 14, 2020 Jkt 250001 been implemented in the Ajo PM10 planning area and that have brought the area into attainment of the Particulate Matter equal to or less than 10 microns in diameter (PM10) National Ambient Air Quality Standards (NAAQS). Our proposed action and related technical support documents (TSDs) contain more information on the rules and our evaluation. III. EPA Action II. Public Comments and EPA Responses IV. Incorporation by Reference The EPA’s proposed action provided a 30-day public comment period. During this period, we received no comments. In this rule, the EPA is finalizing regulatory text that includes incorporation by reference. In accordance with requirements of 1 CFR 51.5, the EPA is finalizing the PO 00000 Frm 00040 Fmt 4700 Sfmt 4700 Pursuant to section 110(k)(3) of the CAA, and for the reasons discussed in detail in our proposed rule and TSDs, and summarized above, the EPA is fully approving MCAQD Rule 316, as submitted on November 19, 2018, and PCC Section 17.16.125, as submitted on May 10, 2019, as revisions to the Arizona SIP. E:\FR\FM\15JYR1.SGM 15JYR1

Agencies

[Federal Register Volume 85, Number 136 (Wednesday, July 15, 2020)]
[Rules and Regulations]
[Pages 42724-42726]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-14341]


=======================================================================
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DEPARTMENT OF VETERANS AFFAIRS

38 CFR Part 17


Update To Access Standards Drive Time Calculations

AGENCY: Department of Veterans Affairs.

ACTION: Guidance.

-----------------------------------------------------------------------

SUMMARY: This Department of Veterans Affairs (VA) document provides 
additional information regarding VA's calculation of average drive 
times for purposes of eligibility determinations for covered veterans 
to access community care through the Veterans Community Care Program.

DATES: Effective August 14, 2020.

FOR FURTHER INFORMATION CONTACT: Joseph Duran, Office of Community Care 
(10D), Veterans Health Administration (VHA), Department of Veterans 
Affairs, Ptarmigan at Cherry Creek, Denver, CO 80209; 
[email protected]; 303-370-1637 (this is not a toll-free number).

SUPPLEMENTARY INFORMATION: On June 5, 2019, VA published a final rule 
at 84 FR 26278 to promulgate 38 CFR 17.4000-17.4040 to implement the 
Veterans Community Care Program established by section 101 of the John 
S. McCain III, Daniel K. Akaka, and Samuel R. Johnson VA Maintaining 
Internal Systems and Strengthening Integrated Outside Networks Act of 
2018 (MISSION Act), Public Law 115-182.
    Section 17.4040 established access standards for purposes of making 
eligibility determinations under the Veterans Community Care Program 
under Sec.  17.4010(a)(4). For primary care, mental health care, and 
non-institutional extended care services, eligibility is established if 
VA cannot schedule an appointment for the covered veteran with a VA 
health care

[[Page 42725]]

provider for the required care or service: (i) Within 30 minutes 
average driving time of the veteran's residence; and (ii) Within 20 
days of the date of request unless a later date has been agreed to by 
the veteran in consultation with the VA health care provider. For 
specialty care, eligibility is established if VA cannot schedule an 
appointment for the covered veteran with a VA health care provider for 
the required care or service: (i) Within 60 minutes average driving 
time of the veteran's residence; and (ii) Within 28 days of the date of 
request unless a later date has been agreed to by the veteran in 
consultation with the VA health care provider. VA noted in Sec.  
17.4040(b) that to calculate average driving time from the veteran's 
residence in paragraph (a) of the section, VA would use geographic 
information system software.
    In the preamble to the final rule, VA explained that it was not 
detailing in regulation a specific methodology for calculating average 
drive time because it was more veteran-centric to maintain operational 
flexibility to refine and improve VA's average drive-time calculations 
in response to experience, feedback and changing real-world conditions. 
See 84 FR 26278, 26299. This final rule further stated that as VA 
gained more experience with administering the Veterans Community Care 
Program and received feedback from veterans regarding their experience 
with the program, VA anticipated refining the tool to calculate average 
drive times as well as VA systems to improve our consideration of 
actual conditions that affect travel to receive care and services and 
to provide more information to veterans regarding calculation of 
average drive times. See 84 FR 26278, 26301. This notice serves to 
inform the public that VA is will change the geographic information 
system software used to the calculate average drive times under Sec.  
17.4040.
    Description of Changes in Calculating Average Drive Times: As 
described in the final rule establishing the Veterans Community Care 
Program (84 FR 26278), VA uses a variety of factors, including 
distance, route options, and speed limits to calculate the average 
drive time between the veteran's residence (as noted in VA's enrollment 
system) and VA facilities that offer the type of care needed by the 
Veteran. The calculation is similar to the calculations used in popular 
commercial mapping software used for point-to-point driving directions 
and estimated travel times. The calculated average is used to determine 
whether the veteran is eligible for community care based on drive time. 
The final rule also stated that, in response to comments that requested 
clarification on how VA will calculate average drive times, that some 
detailed information regarding average drive time calculations and 
algorithms is proprietary, and VA was unable to disclose the full 
method used to make the calculations. See 84 FR 26278, 26300.
    VA recognized the concerns voiced by veterans and members of the 
public at the time we launched the Veterans Community Care Program 
regarding how we calculate average drive time and whether we are making 
the best estimates of average drive times. This notice about planned 
refinements is the result of VA's efforts to continue improving how we 
calculate this important component of eligibility.
    VA is refining the average drive-time calculations in the online 
Decision Support Tool (DST) to improve eligibility determination 
results and response times based on feedback received from veterans and 
VA staff regarding their experiences with the Veterans Community Care 
Program since its implementation on June 6, 2019.
    Effective August 14, 2020, VA will use a new geographic information 
system within DST. Under the new system, VA will determine drive times 
between two addresses by developing ``service areas'' around all VA 
facilities, which are bands surrounding the facility that reflect drive 
times in ranges of 10-minute increments, starting with 0-10 minutes, 
going up to 81-90 minutes. The applicable drive-time standards depend 
on the type of care being requested (i.e., the veteran can get needed 
care within 30 minutes' average drive time for primary care, mental 
health care and extended care services under Sec.  17.4040(a)(1)(i) or 
within 60 minutes for specialty care services under Sec.  
17.4040(a)(2)(i)). Users of the system will get an estimate of the 
drive time between the veteran's residence and the VA facility in a 10-
minute range under the bands, instead of a single-time estimate as in 
the current system. Covered veterans whose residence address is within 
a drive-time service area range that exceeds the drive-time standards 
for the type of care being sought would be determined to be eligible 
under Sec.  17.4010(a)(4).
    The new system will use historical traffic patterns in all 
searches. The system will calculate average drive times based on 
historical traffic patterns on Wednesdays at 10 a.m. at the veteran's 
local time for all searches. We have selected this time and day of the 
week to reasonably approximate times that veterans would be traveling 
for appointments, while working within the capabilities of the system 
and the available data. Historical traffic data will be updated two to 
three times per year to reflect changes in local travel patterns.
    Veterans will benefit from this change in two ways. First, VA 
believes the new system will better reflect the actual conditions that 
affect the time it takes for veterans to travel to receive care and 
services because of the way that historical traffic data will be used 
and how average travel times will be calculated. Second, we can now 
offer more information to veterans and the public regarding how VA will 
calculate average drive times under this new system. While VA is 
primarily making this change to improve eligibility determination 
results and response times, it will also impact eligibility under the 
access standards for some veterans. VA believes the result will be an 
overall increase in eligibility.
    We note that the average drive time is only one element of covered 
veterans' eligibility for community care. Since VA established the 
Veterans Community Care Program on June 6, 2019, covered veterans have 
also been eligible for community care under other criteria (see 38 CFR 
17.4010, Veteran Eligibility). For example, covered veterans who would 
not be considered eligible for community care based solely on the 
average drive time element of the designated access standard criterion 
may still be eligible for community care if the veteran and his or her 
VA provider agree that it is in the best medical interest of the 
veteran to receive community care. We remain committed to ensuring that 
covered veterans are referred to community care where it is in their 
best medical interest, and veterans with concerns about whether they 
should be referred to the community are always welcome to discuss their 
options with their VA providers.
    Although we are changing the method of calculating average drive 
times in our DST tool, which may affect some individuals' eligibility, 
this notice is not changing VA's designated drive time access standard 
under Sec.  17.4040. The average drive times that establish eligibility 
under the designated access standards criterion will remain the same 
after VA updates the average drive-time calculation tool.
    VA continues to believe it is more veteran-centric to maintain the 
operational flexibility to refine and improve VA's calculations in 
response to experience, feedback and changing real-world conditions, 
rather than to detail in regulation a specific

[[Page 42726]]

methodology or considerations that could constrain VA's ability to 
improve the calculation of average drive times in the future. For that 
reason, we will continue to update the public through documents in the 
Federal Register about any changes to how we calculate average drive 
times for the Veterans Community Care Program.

Signing Authority

    The Secretary of Veterans Affairs, or designee, approved this 
document and authorized the undersigned to sign and submit the document 
to the Office of the Federal Register for publication electronically as 
an official document of the Department of Veterans Affairs. Brooks D. 
Tucker, Acting Chief of Staff, Department of Veterans Affairs, approved 
this document on June 23, 2020 for publication.

Jeffrey M. Martin,
Assistant Director, Office of Regulation Policy & Management, Office of 
the Secretary, Department of Veterans Affairs.
[FR Doc. 2020-14341 Filed 7-14-20; 8:45 am]
BILLING CODE 8320-01-P


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